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Industry bugaboo: A patchwork of AI rules

The ideas and innovators shaping health care
Nov 16, 2023 View in browser
 
Future Pulse

By Shawn Zeller, Evan Peng, Carmen Paun, Daniel Payne, Ruth Reader and Erin Schumaker

TECH MAZE

A doctor looks at a hand on a computer screen.

The telemedicine business sees consistent rules for AI as a must. | J Pat Carter/AP

The telemedicine industry sees the importance of regulation when it comes to artificial intelligence in health care — it just wants the rules to be consistent.

The American Telemedicine Association, which represents players in the industry, including Google, Facebook and Salesforce plus universities, health systems and doctors, has released principles it thinks should guide AI’s adoption.

Yes, and: The association wants regulators to ensure that AI works, it doesn’t produce inaccurate or biased results and it has ongoing oversight.

It wants the federal government to lead the way.

States, it says, should prioritize alignment with federal rules and, if they do pursue their own regulations, should seek to harmonize them with each other.

Ideally, the association says, the United States should seek to align its rules with those of foreign countries.

What else? The group says makers of AI products must be transparent about what’s guiding the products’ decision-making and open to scrutiny and oversight.

Those using AI should be cognizant of their impact on the health care workforce and retrain workers displaced by technology to perform new roles.

Health care providers that use AI must ensure the privacy of patient data. The association has a “data work group” that’s creating a roadmap to that end.

 

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WELCOME TO FUTURE PULSE

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Tabernash, Colo. | Shawn Zeller/POLITICO

This is where we explore the ideas and innovators shaping health care.

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Today on our Pulse Check podcast, host Alice Miranda Ollstein talks with POLITICO health care reporter Robert King, who explains why the lack of a year-end omnibus spending bill creates uncertainty for doctors seeking 11th-hour legislation to avert Medicare physician payment cuts.

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WORKFORCE

Jamar Williams looks through a microscope during a class while attending the Latin American School of Medical Sciences in Havana, Cuba in 2006.

The next generation of clinicians is skeptical about serving patients. | Joe Raedle/Getty Images

Medical and nursing students in the U.S. and around the globe are planning careers outside patient care due to fears of overwork and burnout, a new report found.

The report from Elsevier Health, an academic publisher, is based on a survey of more than 2,200 students from 91 countries and paints a picture of a field in deep trouble.

The survey found that most medical and nursing students in the U.S. are worried about their mental health and believe they will suffer from burnout as a clinician.

Nearly a quarter are considering quitting their studies.

Even among those not considering quitting, fears about the industry are having an effect. The report found that 58 percent of medical and nursing students globally see their current studies as a means toward a broader career in health that won’t involve patient care.

Why it matters: The medical field is already facing significant clinician shortages. A 2021 report from the Association of American Medical Colleges found a shortage of 19,800 doctors in the U.S. in 2019 and projected a shortage of physicians between 37,800 and 124,000 by 2034.

Complaints of understaffing have driven recent labor actions in the medical field.

Legislative movement: The Senate Health, Education, Labor and Pensions Committee advanced a $26 billion primary care bill last month that included provisions for bolstering the health workforce, including $1.2 billion for two-year nursing education programs and $300 million for primary care physician education.

 

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THE NEXT CURES

A microscope photo shows crescent-shaped red blood cells from a sickle cell disease patient in 1972.

Sickle cell disease afflicts people of color in the United States at higher rates. | Dr. F. Gilbert/CDC via AP

In a global first, the United Kingdom today approved a treatment for a group of rare blood diseases, including sickle cell, that uses the CRISPR gene editing technology to fix a patient’s genes.

The medicine, called Casgevy, was developed by two companies in the United States, Vertex Pharmaceuticals and CRISPR Therapeutics. It treats sickle cell disease and transfusion-dependent beta thalassemia, two inherited diseases that affect patients’ red blood cells, POLITICO’s Carlo Martuscelli reports.

In the U.S., advisers to the Food and Drug Administration considered evidence from the manufacturers last month.

Why it matters: Sickle cell disease is a genetic disorder that results in deformed red blood cells with a faulty version of the protein hemoglobin, which delivers oxygen across the body. These malfunctioning cells can lead to complications including extreme fatigue, blood vessel blockages and debilitating pain that can require hospitalizations.

A 2019 study calculated the average life expectancy for those with sickle cell disease is 54 years compared to 76 years for those without the condition, and patients and their insurers may spend a total of between $1.6 million and $1.7 million managing the condition over the course of a lifetime.

According to the Centers for Disease Control and Prevention, there are roughly 100,000 people in the U.S. living with sickle cell disease, most of whom are people of color. One of every 365 Black or Americans with African ancestry have the disease, as do one of every 16,300 people of Hispanic descent.

There are drugs that treat symptoms, including stem cell transfusions, but only stem cell transplants potentially cure the disease’s underlying cause. Stem cell transplants must come from a genetically matched healthy donor and put patients at risk of serious side effects, including death.

What’s next? The FDA is expected to decide whether to approve the new treatment in the U.S. next month.

 

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